George M Savva1, Blossom C M Stephan. 1. University of Cambridge, Institute of Public Health, Robinson Way, Cambridge CB20SR, UK. george.savva@phpc.cam.ac.uk
Abstract
BACKGROUND AND PURPOSE: Stroke is implicated in the incidence of dementia, and the risk of poststroke dementia is well characterized, but the excess risk of dementia in those with stroke compared with those without stroke is not well known. METHODS: We conducted a systematic review of the excess risk of incident dementia conferred by stroke. Studies of the risk of incident dementia in the population with stroke compared with the population without stroke were identified and compared. RESULTS: Sixteen studies were identified with all but one conducted in a community setting. A history of stroke doubles the risk of incident dementia in the older population. This increase is not explained by demographic or cardiovascular risk factors or by prestroke cognitive decline. The excess risk of incident dementia diminishes with time after stroke and may be higher in those without an APOE epsilon4 allele. There is no excess risk of incident dementia in those aged >85 years with a history of stroke compared to those aged >85 years without stroke. CONCLUSIONS: The effect of stroke on dementia incidence in the population is not explained by common risk factors. At this time of population aging and increased stroke survival, more research is needed to determine to what extent efforts to reduce the incidence of stroke will affect the incidence of dementia.
BACKGROUND AND PURPOSE:Stroke is implicated in the incidence of dementia, and the risk of poststroke dementia is well characterized, but the excess risk of dementia in those with stroke compared with those without stroke is not well known. METHODS: We conducted a systematic review of the excess risk of incident dementia conferred by stroke. Studies of the risk of incident dementia in the population with stroke compared with the population without stroke were identified and compared. RESULTS: Sixteen studies were identified with all but one conducted in a community setting. A history of stroke doubles the risk of incident dementia in the older population. This increase is not explained by demographic or cardiovascular risk factors or by prestroke cognitive decline. The excess risk of incident dementia diminishes with time after stroke and may be higher in those without an APOE epsilon4 allele. There is no excess risk of incident dementia in those aged >85 years with a history of stroke compared to those aged >85 years without stroke. CONCLUSIONS: The effect of stroke on dementia incidence in the population is not explained by common risk factors. At this time of population aging and increased stroke survival, more research is needed to determine to what extent efforts to reduce the incidence of stroke will affect the incidence of dementia.
Authors: Yael D Reijmer; Panagiotis Fotiadis; Sergi Martinez-Ramirez; David H Salat; Aaron Schultz; Ashkan Shoamanesh; Alison M Ayres; Anastasia Vashkevich; Diana Rosas; Kristin Schwab; Alexander Leemans; Geert-Jan Biessels; Jonathan Rosand; Keith A Johnson; Anand Viswanathan; M Edip Gurol; Steven M Greenberg Journal: Brain Date: 2014-11-02 Impact factor: 13.501
Authors: Prativa Sherchan; Fayth Miles; Michael Orlich; Gary Fraser; John H Zhang; Konrad Talbot; Penelope J Duerksen-Hughes Journal: Transl Stroke Res Date: 2020-02-15 Impact factor: 6.829